Cerebral Venous Thrombosis | Diagnosis & Treatment

How is cerebral venous thrombosis diagnosed?

If a physician suspects that your child has cerebral venous thrombosis (CVT), they will conduct a physical exam and take a thorough medical history. They may also recommend certain diagnostic tests, such as:

How is cerebral venous thrombosis treated?

If your child experiences symptoms of CVT or stroke, you should seek immediate medical treatment. Once you have arrived at the emergency room, physicians will treat CVT based on your child’s individual case, including their age and the underlying cause of the blood clot. Treatment options include:

  • intravenous fluids to address to dehydration
  • medications to help prevent blood clots
  • medications to help prevent seizures
  • minimally invasive endovascular techniques
  • rehabilitation after stroke

Previously, clinicians were reluctant to treat CVT with anticoagulants, which themselves can pose some risks, but confidence has grown in using these medications to prevent injury from the blood clot in selected newborns and children. These children are closely monitored by the Thrombosis and Anticoagulation Program at Boston Children’s, which collaborates closely with the Stroke and Cerebrovascular Center.

If medications are not enough to clear the blood clot, physicians in Boston Children’s Cerebrovascular Surgery and Interventions Center may perform endovascular thrombolysis. This emergency treatment, performed under general anesthesia during a cerebral angiogram, guides a very small catheter into a part of the brain called the cerebral venous sinus to introduce balloons, suction devices or other tools to break up the clot or even extract it from the vessel. In some cases, clot-dissolving drugs such as tissue plasminogen activator (tPA) are delivered through the catheter, right at the blockage.